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WASHINGTON, DC - SEPTEMBER 18: Senate Minority Leader Charles Schumer (D-NY) talks about the possibility of the Senate taking up healthcare again during a news conference on Capitol Hill September 18, 2017 in Washington, DC. Schumer said the proposed Graham-Cassidy bill would cause many millions of people to lose coverage. (Photo by Mark Wilson/Getty Images)

The American Medical Association joined a parade of patient advocates, healthcare groups and the largest senior lobby to oppose the Republican-led Senate’s latest effort to overhaul the Affordable Care Act, saying it would lead to millions losing coverage and hurt Americans with pre-existing medical conditions.

The bill introduced last week by Sens. Lindsay Graham (R-South Carolina), Bill Cassidy (R-Louisiana), Dean Heller (R-Nevada) and Ron Johnson (R-Wisconsin) would keep a lot of the ACA’s regulations intact, though it would eliminate the individual and employer mandate and also shift insurance subsidies and Medicaid funding for coverage of poor Americans to block grants controlled by states.

"Proposals should maintain key insurance market reforms, such as coverage for pre-existing conditions, guaranteed issue, and parental coverage for young adults; stabilize and strengthen the individual insurance market; ensure that low- and moderate-income patients are able to secure affordable and meaningful coverage; and guarantee that Medicaid, the Children’s Health Insurance Program (CHIP), and other safety-net programs are adequately funded," AMA CEO Dr. James Madara said in a letter to Senate Republican leader Mitch McConnell and Democrat Chuck Schumer, the Senate minority leader.

“Unfortunately, the Graham-Cassidy Amendment fails to match this vision and violates the precept of 'first do no harm,'"AMA's Madara added in his letter. “Similar to proposals that were considered in the Senate in July, we believe the Graham-Cassidy Amendment would result in millions of Americans losing their health insurance coverage, destabilize health insurance markets, and decrease access to affordable coverage and care.”

In restructuring Medicaid to a “per-capita cap funding mechanism,” the new Senate legislation would replace Medicaid’s existing open-ended entitlement structure paid for via a match of funds between the states and federal government. If a particular state Medicaid program is faced with a large number of people in need of expensive medicines or treatments, more federal dollars flow to the state.

"Per-capita-caps fail to take into account unanticipated costs of new medical innovations or the fiscal impact of public health epidemics, such as the crisis of opioid abuse currently ravaging our nation," AMA's Madara said.

Because federal dollars for Medicaid account for about 20% of state budgets, noted financial firm Fitch Ratings said it “believes substantial Medicaid cuts would require states to make material budget adjustments over the next decade and beyond.”

AARP said the Graham-Cassidy bill would increase health care costs for older Americans with "an age tax, decrease coverage, and undermine pre-existing condition protections," the group said in its statement. "In addition, this bill would jeopardize the ability of older Americans and people with disabilities to stay in their own homes as they age and threaten coverage for individuals in nursing homes."

The groups would rather see the Senate support the bipartisan approach that began in recent weeks in the Senate HELP committee where Republicans led by Sen. Lamar Alexander and Democrats led by Sen. Patty Murray are working on ways to fix the ACA by shoring up the public exchanges where individuals buy subsidized health plans.

The health insurance industry, led by America's Health Insurance Plans, is also advocating a bipartisan fix. AHIP's members include Anthem, Centene, Oscar Health, Molina Healthcare and several Blue Cross and Blue Shield plans. Oscar Health and Centene have been among the health plans that have expanded into new Obamacare markets for 2018.